Apparatus for radium therapy applied in the cavity of the body



March 13, 1951 Filed Aug. 22, 1946 A. M. RITALA 2,544,939 APPARATUS FORRADIUM THERAPY APPLIED IN THE CAVITY OF THE BODY 5 Sheets-Sheet 1AaroMiKnel Rfrahl IINVENTOR My ATTYs.

March 13, 1951- A. M. RlTALA APPARATUS FOR RADIUM THERAPY APPLIED IN THECAVITY OF THE BODY 3 Sheets-Sheet 2 Filed Aug. 22, 1946 Aaro MikaelRd'am INVENTOR RLQ ATT'Ys.

March 13, 1951 A. M. RITALA 2,544,939

APPARATUS FOR RADIUM THERAPY APPLIED IN THE CAVITY OF THE BODY FiledAug. 22, 1946 s Sheets-Sheet 3 INVENTOR Aaro Mlkael Rfiala.

Patented Mar. 13, 1951 OFFICE APPARATUS FOR RADIUM: THERAPY AP- PLIED INTHE CAVITY OF THE BODY Aaro Mikael Ritala, Turku, Finland ApplicationAugust 22, 1946, Serial No. 692,241 H In Finland March 6, 1945 2 Claims.(01. 12s 1.2)

In giving radium treatment to patients with cancer it is, oftendifficult to prevent the injurious effect of radium on healthy tissuesand simultaneously treat the cancer with the radium as effectively aspossible. This of course is the more difficult the deeper the cancer tobe treated lies in some part of the human body. Up until now treatmentof vaginal cancerous condition by means of radium packings surrounded bya lead casing 3 mm. thick, tamponed into place and radiating in alldirections equal amounts of v-rays per unit-area, have been usuallyused. The edges of the packing easily come into too close contact withthe healthy, sensitive organs, e. g. in the case in question too closeto the bladder or rectum or both, whereby the danger of injuring thelast mentioned organs is very great, especially if the vagina is dilatedlaterally.

Research work done in this field has proven that while the effect ofradium is directly proportional to the quantity of radium used and tothe radiating surface area and to the length of radiation time it isinversely proportional to the radiation distance and to the thickness ofthe filtering medium that is used. In order to obtain an effectivetreatment of the carcinoma, the radium quantity, the area of theradiating field and the length of the radiation time should be increasedas much as possible, while the injurious effect of the rays on healthytissues is best avoided by increasing the radiation distance, while inother work the distance between the radium and the healthy tissues iseffected by using a suitable filtering medium. The fulfillment of theseconditions implies that the radium packing can be placed as precisely aspossible into its specified position.

This invention relates to an apparatus for radium treatment applied in acavity of the body, especially for vaginal carcinoma therapy, and theapparatus consists of a dilator (also called a distancer in thedorso-ventral direction) to which one or moreadjustable supporters forthe radium packing is detachably attached. In order that the apparatusbe practical the provision of a scale is advisable, whereby the centredistance of the dilator arms can be read in centimeters. The arms of thedilator can be moved separately in such a way that the increase ordecrease of the centre distance caused by the movement can be read,according to the invention, from the scale. In this way the centredistance of the outer dilator arms is always known.

The supporters, equipped with casings for the radium packings, areconstructed in such a way that the length thereof, in other words thedising from the fixing point in the back portion of the dilator, and theclearance angle thereof can be regulated. The casing for the radiumpack-- ing is made of material absorbing 'y-rays, e. g. lead, in such away that one side or part of the casing is open thus forming a windowwherethrough radiation is free. Thus the radium rays are directedtowards the carcinoma itself in the most accurate and practical way. Theheavy, lead casing keeps in place during the treatment because theposition thereof is not dependent on certain tampons. During thewholetreatment pus can flow away freely. After the dilator has been placedinto the vagina and the dilation thereof has been effecteddorso-ventrally (not laterally) the supporters of the radium casing orcasings are fixed into position. For protecting the adjacent healthytissues (the bladder and the rectum) a protective slab made of lead orsome other suitable material can be attached to the arms of the dilator.These slabs vary in size and thickness and are used as the case may be.

' The accompanying drawings illustrate "a me ferred embodiment andaccessories pertaining thereto of the invention. Fig. 1 illustrates thedilator carrying three supporters for the casings containing the radiumpackings, the adjustment and fixing means being attached, and shownpartly in section. Fig. 2 illustrates parts of the dila tor not shown inFig. l, viz. the screws for moving the arms and the lever system, bymeans of which every movement of the arms is registered on a scale, forclearness sakepartly schematically. Fig. 3 illustrates an arm of thedilator equipped with the protective slab, viewed from the inside of thedilator. Figs. 4 and 5 are side and plan views respectively of the armof the dilator equipped with a locking device by means of which theprotective slab is fixed. Figs. 6 and 7 are side and bottom plan viewsrespectively of the protec tive slab and Fig. 8 is a cross section alongline II of Fig. 3. I

' The arms I and 2 of the dilator are attached in a well known manner tohandles 3 and 4 and turn around a common pivot 5 in such a way that thedistance between said arms can be decreased or increased. This isachieved by means of screw tance of the casing containing the radiumpack- 6 (Fig. 2). In order to adjust and fix the centre distance in apredetermined degree the one handle 4 of the dilator is provided with ascale 1 projecting from the pivot 5 while the extension of the otherhandle 3 is shaped into an indicator 8. The numerals on the scaleindicate directly the centre distance of the arms ofthe dilator incentimeters. In addition to the fact that the arms I and 2 are able toturn around pivot 5, said arms may also be turned each around its ownpivot 9 and H! by means of screws H and I2 and also this movementaffects scale I or indicator 8 by means of levers l3, [4 and in thefollowing manner: As an extension to the arm of the dilator there is alever 13, the end of which is joined. by means of av pinto lever 54.This lever is fixedby means of screw IE to handle 4. The other end oflever 14 is joined by means of a pin to scale I and the end of thecorresponding lever on the other handle is joined to the indicator 8.When the arms turn around pivot 5, lever I4 is out of operation, andboth arms open at the same time in the directions indicated with arrowsat. The dash lines and arrow b illustrate another opening position ofthe one arm and another position of the lever system pertaining theretowhen screw 12 is turned.

Between the arms i and 2 there are three supporters. with casings forthe radium packings. The supporter rods Ii, I8 and [9 (Fig. 1) arejoined to the dilator by means of special screws. At the end of botharms I and 2 there is a conical screw equipped with male threads and atsaid screw there is a clamping wedge 2!. By tightening nut 22 the fixingpin 23 passing through said screw is fastened to the same. The crosssection of fixing pin 23 is square and said pin is provided with a ball24 at the other end. In socket 21 there are holes wherethrough the supporter rod I1 is run. When nut 25 is tightened the supporter rod I! isfixed to fixing pin 23. Ball 24 makes possible the fixing of rod ll intoa quite determined position with regard to fixing pin 23. The othersupporter rods [8 and 19 can be fixed in the same way by means of screws25' and 25" to the respective fixing pins. The third conical screw, notshown in the drawing, can e. g. be fixed to the handle 3 of the dilator.

The supporters for the radium packings themselves consist of casingsfixed to the supporter rods ll, 18 and I9 by means of ball jointsidentical with the ones previously described. At the. end of rod I!there is a ball 28, fitting into a screw piece 2! fixed to thesupporting case 30. Nut 29 fixes the ball to the screw. The supportercasings may vary in shape depending on the radium packing used, but allhave a window opening to a certain direction or directions.

The cross section of casing 30 is a right angled box with walls andbottom made of lead or some other suitable material absorbing radiumrays leaving window" 3! free for radiation. By right angled box is meantcasing 30, the parietal por-- tions whereof lie in mutuallysubstantially perpendicular planes. tended for radium packings of agenerally cylindrical or semi-cylindrical configuration and thereforehave the form of half a cylinder with bottom or lid that can be openedand closed for inserting the packing therein.

If protection of the sensitive organs lying under the arms of thedilator from the rays be desired, protective slabs 34 (Figs. 3-8) madeof lead or some other suitable material absorbing radium rays are fixedto the one or both arm or arms of the dilator. For fixing such a slabthe inside of arm I is provided with a notched rod 35 where on cap 38 onthe back side of the protective slab fits. A cog 38 on. the lock 3'!attached to the cap fits into the notch of rod 35.

' The protective slab can thus be fixed by press- Casings 32 and 33 areinsition after the dilator has been positioned and the protective slabsmay vary in size and thickness. The aperture 39 on the other arm 2 ofthe dilator is for the canulizator of the bladder.

In detail the dilator can be constructed in a different manner withoutdeparting from scope and spirit of the invention. So e. g. the arms ofthe dilator can be of diiferent shape. In the drawings thecross-sections of said arms are curved, but they can also be straight.The protective slabs can vary in size and be attached in a differentmanner. The casings for the radium packing may be of any desired shapethat will afford the requisite window opening into one direction for therays. The walls of the casing may vary in thickness in differentdirections. The casings may be attached to the rods in a differentmanner e. g. by placing the ball at the end of the arm into a springsocket provided in the casing wherein said ball can freely turnbut.where from it simply cannot detach itself.

I claim:

1. A therapeutic instrument for vaginal irradi-- and the applicativeportion thereof including av plurality of arms situated between anddirectly supported by said dilative arms, means ad,acent the extremityof each applicative arm within the body cavitiesv for holding anirradiative instrumentality, and means for adjusting said applicativearms independently, whereby location of said irradiativeinstrumentalities may be determined at respective points remote withrelation to the position of said dilative arms.

2. An instrument according to claim 1, wherein a radiation shield islocated upon at least one; of said dilative arms.

AARO MIKAEL RI'I'ALA.

REFERENCES CITED The following references are of record the file of thispatent:

UNITED STATES PATENTS Number Name Date 1,525,158 Viol Feb. 3, 1925FOREIGN PATENTS Number Country Date 227,654 Great Britain Jan. 22, 1925.250,936 Italy Nov. 18, 1926 273,427 Germany Apr. 2'7, 1914 330,629 GreatBritain June 16, 1930: 699,329 Germany Nov. 27, 1940 OTHER REFERENCESRadium Therapy, by C. W. Wilson, published by Chapman and Hall Ltd.,London, page 159. (Copy available in Div. of the U. S- Patent Office.)

Catalog of Radium and Accessory Equipment. for Modern Radium Therapy, byCanadian Radium and Uranium Corp" New York city, New York, Figure 403,page 7. (Copy available in Div. 550i the-U. S. Patent Office.)

